小剂量右旋美托咪啶对老年高血压患者围麻醉期间血压的影响  

Effects of dexmedetomidine on blood pressure in old hypertesion patients undergoing spinal-epidural combined anesthesia

作　　者：杨敬涛[1] 甯交琳[1] 曹剑[1] 易斌[1] 崔健[1] 陶国才[1] 聂发传[1] 

机构地区：[1]第三军医大学西南医院麻醉科,重庆400038

出　　处：《重庆医学》2010年第17期2310-2311,共2页Chongqing medicine

摘　　要：目的探讨小剂量右旋美托咪啶对老年高血压患者围麻醉期间血压的影响。方法将65-70岁、ASAⅡ-Ⅲ级接受前列腺汽化切除的高血压患者75例,随机分为对照组、咪唑安定组和右旋美托咪啶组;于入手术室后,对照组采用生理盐水滴鼻,咪唑安定组静脉注射咪唑安定2 mg,右旋美托咪啶组右旋美托咪啶2 mg/kg滴鼻;观察并记录入室时、给药后5 min、麻醉后30 min、麻醉后2 h血压、心率及脉搏血氧饱和度（SpO2）。结果对照组患者入室后收缩压、心率均有所增加,咪唑安定组患者收缩压和心率无明显改变,给药后5 min SpO2有所下降,托起下颌辅助呼吸可缓解;右旋美托咪啶组收缩压有所下降,心率和SpO2无明显变化,麻醉后低血压发生率无增加趋势。结论小剂量右旋美托咪啶滴鼻可对老年高血压患者产生明显的镇静作用和轻度的中枢降压效果,增强围麻醉期循环稳定,而不产生呼吸抑制作用,可协助老年高血压患者平稳度过围麻醉期。Objective To investigate the effects of dexmedetomidine on peri-operation periods blood pressure of old hypertension patients.Methods 75 patients who were 65-70 years old,ASA Ⅱ or Ⅲ undergoing prostate vaporized excision were randomly divided into three groups：control group,midazolam group and dexmedetomidine group.Blood pressure,heart rate and SPO2 was recorded at pre-admistration,5 min after ad ministration,30 min and 2h after anaethsia.Results Contractive pressure and heart rates were increased in control group.Contractive pressure and heart rates were no more or less changed in midazolam group,SPO2 was decreased to（89.4±3.2）% at 5 min after ad ministration,raising submaxilla could relieve respiratory inhibition resluted by midazolam.Contractive pressure in dexmedetomidine group was decreased gently,the incidence rate of hypotension was not increased.Conclusion Circulation is stabilized in anesthetic phase by small dose dexmedetomidine administrated by dropping nasal with sedation and center depressurization,which can be helpful for safety of peri-operation of old hyprtension patients.

关 键 词：右旋美托咪啶 高血压 围麻醉期 

分 类 号：R614[医药卫生—麻醉学] R544.1[医药卫生—外科学]